Week 1 on psych ward

Day 2

• Four hour training workshop on how to use the computer record keeping system.
• Back to the psych unit and buddied up with one of the nurses. Went round with her to meet the patients. Part of the nurse’s duties is to check on the patients every 30 minutes or hour (depending on their risk level) and record where they were and what they were doing. This is a legal document (duty of care). Some patients burst into rambling talk when you say hi to them and I’ve noticed that sometimes the nurses just walk away while they’re doing that. At first I thought it was rude but what else can you do. You could spend half an hour just standing their listening to the nonsense coming out of their mouths.
• Besides that, just gave out meds when they were due, including one anti-psychotic injection in the arm, and responded to patients’ requests. One patient requested use of the boxing gloves which they can use if they want to punch the wall or whatever to release frustration, then I had to take them back off him 10 minutes later when I realized he was using them to have a real boxing match with another patient.

Day 3• In the morning, the clinical placement officer from my university called me to and told me there had been a ‘mix up’ which was why the psych ward had no idea I was coming, but that she’d talked to them and ‘luckily they will take me’. Found out later that actually my clinical educator on the ward had called her and slightly reprimanded her for not organizing my placement properly, and insisted she call me and apologise because it must have been a bit stressful for me after driving all the way up from Melbourne. Hah! Some apology. My uni is incapable of ever admitting to making mistakes. Everything is the students’ fault and we should just be grateful for all the hard work they put into getting our placements at all times. I’m so over complaining. I just want to get through the rest of my course now, get my degree and get on with my nursing career.
• Back to my placement - the mental health nurses on the ward all seem like a really nice bunch of people. They are very welcoming and helpful. Today I chaperoned a patient to another part of the hospital to get an echocardiogram. That’s an ultrasound of the heart and needs to be done before commencing Clozapine treatment for psychosis. The drug can cause myocarditis, an infection of the heart muscle, so the heart has to totally free of any pre-existing heart disease. It’s a last resort treatment when other drugs haven’t worked.

Typical day for the mental health nurse:• Handover (1 hour)
• Unit rounds, check on the patients
• Give out meds when they are due
• Do any obs as required such as vital signs, alcohol or drug withdrawal scale, weight, or wound dressings.
• Participate in activities with patients
• Attend to the patients’ issues and requests, including counseling, admissions and discharges.
• Write up file notes.

Day 4• Two hour manual handling workshop. Learned how to use all the special equipment for moving patients. Probably won’t need this on my placement because on the psych ward the patients are not immobile but it’s a requirement for anyone working or doing a placement at the hospital.
• After that I went back to the ward and this time I was placed in the High Dependancy Unit. This is the section for patients that need to be checked on every 15 minutes because of suicide risk or risk of ‘misadventure’ which means they are likely to do crazy things such as have sex with another patients or start a fight with another patient. The nurses stay behind a screen to keep an eye on them and for their own safety. Even the chairs in there are all soft so they can’t do any damage. Their cigarette intake is controlled (eg. no more than one per hour) and the nurses have to give them their cigarettes and light them for them. Usually they don’t let students work in that unit until the third or fourth week of their placement so it was pretty cool that they thought I could handle it. The patients in that section are pretty scary.